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    The Latest Research: April 2020 Interesting look at schizophrenia and bipolar disorder

    The Latest Research: April 2020
    Interesting look at schizophrenia and bipolar disorder
    By Hugh Brady

    One of the problems in treating schizophrenia and bipolar disorder is that the conditions may not be single diseases at all. Instead they may be sets of symptoms with different causes. Half a dozen or more different malfunctions may lead to a common set of symptoms.

    This is similar to other conditions. Abdominal pain, for example, can have many different causes. It may be an ulcer, some sort of cancer, food poisoning, a food allergy, infection, or one of any number of other conditions. Treatment, of course, will depend on the cause. Stomach cancer is treated much differently than ulcers or allergies.

    The same may be true of some mental illnesses – different underlying causes will necessitate different kinds of treatment. But the difficulty is the lack of identified biomarkers for what may be different causes. An X-ray can identify a tumor. A camera probe can locate an ulcer. Allergy tests can identify allergens. But there are no clear biomarkers for what may be the different sets of symptoms now called schizophrenia and bipolar disorder.

    That may be about to change.

    Some recent studies have found that a recently discovered autoimmune disease with the jawbreaker name “anti-NMDA receptor encephalitis,” may be responsible for a significant number of cases where external symptoms would lead to a diagnosis of schizophrenia or bipolar disorder.

    Autoimmune disorders are when, for some reason, the body’s immune system starts creating antibodies that attack parts of the body itself instead of bacterial or viral invaders. One of the better known autoimmune diseases is multiple sclerosis, where the person’s immune system attacks the myelin sheath that surrounds nerve axons, leading to movement disorders and even paralysis.

    One article on anti-NMDA receptor encephalitis noted that the N-methyl-D-aspartate (AKA NMDA) receptor is, “an important protein found on the surface of many nerve cells that allows them to receive signals from other nerve cells. The receptor is found throughout the brain and is involved in the formation of new memories” as well as in perception and judgement. In anti-NMDA receptor encephalitis a person’s immune system for some reason begins creating antibodies that cap the ends of some neurons, preventing nerve signals from crossing the synapses that normally allow the transmission of signals from neuron to neuron. When that happens, the symptoms of schizophrenia or bipolar disorder can appear.

    When capped by immune system antibodies in this manner, the nerve cells remain intact, however, and normal brain function can be restored by treating the person with existing immunotherapy medications which rid the body of these antibodies.

    Dr. Joseph Masdeu, of Houston Methodist Neurological Institute, one of the leading researchers in this area, noted “We suspect that a significant number of people believed to have schizophrenia or bipolar disorder actually have [anti-NMDA receptor encephalitis]. We are trying to perfect a method that will allow us to detect [these] antibodies in people with greater sensitivity. If we find that even some of these schizophrenia patients do have antibodies, then we can cure them, which would be incredible.”

    Stay tuned for further developments.

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